When It Comes to Health Care Reform

With all the talk of reforming health care, what if we are missing the bigger picture?

What if all this emotional debate about whether to dismantle the Affordable Care Act, otherwise known as Obamacare, was a waste of time?

In 2013, I was asked to give a TED Talk in Washington, D.C. to coincide with the rollout of the Affordable Care Act. I was to follow the Surgeon General; the Director of the National Institutes of Health; and a well-known Harvard Business School professor, among others.

With all the talk of reforming health care, what if we're missing the bigger picture?

I immediately said, “No thanks!” I didn’t want to be like Frank Gorshin, the impersonator who came on the Ed Sullivan Show right after the Beatles made their American debut. After some cajoling, I agreed to do the event with the stipulation that I could invite a panel of health care innovators and pretend to be Oprah.

Surprisingly, they agreed.

Top innovators from Google, AT&T, Lockheed Martin, and Qualcomm joined me in a very pleasant, non-confrontational discussion about how health care was being changed from the outside in.

We discussed the use of smart phones to perform physical exams in record time for less than $15, diagnosis of diseases like river blindness with the addition of a cheap lens attachment for handheld devices, crowdfunding the discoveries of new drugs, and using open-source informatics to create inexpensive and customized therapies, and more.

In the weeks that followed, I received a few polite but passive-aggressive emails from people I took to be seasoned physicians. The message was usually the same. “You don’t understand how we do things because you are not a doctor.”

I also received several emails from medical students and residents. Their messages went something like this: “The attending physicians in my medical center are terrified of new technology, please send help.”

Finally, I received numerous inquiries from young entrepreneurs who wanted to be outside-in innovators themselves. Most of them were looking for moral support, industry connections, and large amounts of cash.

"While we are lobbying and legislating the future of health care in America, innovators are creating the products and services that will largely determine what that future looks like."

It was clear that all three groups belonged to the same health care ecosystem but with much more eco and much less system.

What has been conspicuously absent from the discussion about reforming health care is the role innovation is playing in making it better, faster and cheaper. While we are lobbying and legislating the future of health care in America, innovators are creating the products and services that will largely determine what that future looks like.

Ideally, doctors would be leading the effort, but they are falling behind the pace of the innovators. The irony is that health care is great at developing timely new therapies but terrible at operationalizing them. It’s a difficult balancing act. We expect our physicians to follow the rules so that we get predictable results. But if we don’t give them room to try new things, innovators will come from somewhere else.

Over the past few years I’ve been working with some of the leading medical institutions to teach students and physicians how to make innovation happen from the outside-in. The results have been promising so far, but there is much more to do before we see any real impact on the availability and affordability of health care. Its future will obviously be affected by the decisions of our elected representatives—but the ideas coming from these outside-innovators may matter more in the end.